In spite of the tremendous successes of dental implants, the reality of dental implant failure has become an increasingly important topic with the growing frequency of implant placement. Occasional problems aside, dental implants are the treatment of choice today for missing teeth.
What Are Dental Implants?
Dental implants are basically man-made artificial tooth roots that can be used in a variety of ways to replace lost or missing teeth and support fixed or removable dental prostheses. They are typically made from medical-grade titanium, although new materials, such as zirconia, are also gaining popularity. The modern era of dental implants began with Dr. Per-Ingvar Branemark, an orthopedic surgeon in Sweden, who placed the first root form dental implant in the 1960s, says Encyclopaedia Britannica. According to Dental Products Report, more than 500,000 dental implants were placed in the U.S. in 2017, and that number is only increasing.
What Makes Implants Fail?
Dental implant failures can occur for several reasons and on many levels. Short-term failures can mostly be described as a failure to heal in the bone, a process called "osseointegration." This type of failure can be associated with systemic factors, such as smoking, uncontrolled diabetes or low bone density, writes the Academy of Osseointegration. Poor oral hygiene and gum disease can also put you at risk for a failed implant.
The symptoms of a failing implant may include pain, mobility of the implant fixture (the part of the implant that is submerged in the jaw bone), bone loss, bleeding, the formation of pus and certain X-ray findings around the implant. These short-term failures can often be treated by removing the implant, repairing the surgical site with a bone graft and allowing it to heal before attempting to place another fixture. Since bone heals much more slowly than soft tissue, this process can take several months.
What Are Long-Term Implant Problems?
Long-term dental implant failure presents an entirely different set of challenges. They can occur after the implant has healed and become integrated in the bone, and after an implant has been restored. The most common long-term failure (and unfortunately the most difficult kind to treat) is called peri-implantitis. Peri-implantitis is a chronic infection in the gum and ultimately the bone that supports the implant. It may be likened to the periodontal disease process affecting teeth, since both result in the loss of the supporting structure (bone) around a fixed part. Symptoms may include discomfort and pus or bleeding from the gums.
Treatments for peri-implantitis can include improvements in home care, more frequent cleanings, laser therapies, antibiotics and surgery to restore the bone. Although the overall success rate of dental implant therapy has been reported as high as 98 percent (according to the American Academy of Implant Dentistry), the effectiveness of treatments for peri-implantitis is much lower, especially when you take into consideration some of the accompanying consequences such as the changed appearance of the restoration.
Other long-term failures can include prosthetic complications, such as broken screws, abutment loosening and fractured restorations. These can also be associated with loss of function and cosmetic changes. Fortunately, most of these situations are more easily corrected than peri-implantitis!
Your dental professional may be a member of the Academy of Osseointegration or the International Congress of Oral Implantologists and will be able to answer all of your questions about dental prosthetics. See your dentist for regular cleanings and maintain good oral care at home to protect your implants and the tissues around them.